Global Health Governance: The Indispensable Role of National Health Systems
Margaret Chan | October 15, 2015
Responding To: WHO Director-General Continues Georgetown's Conversation on Global Governance
François Pazisnewende Kaboré
Dr. Chan’s powerful address ends with a question: “Do you think the international community can compensate for the absence of strong health systems with surveillance and laboratory capacity in any given country?”
This important question acknowledges the fact that most national health systems, especially in developing countries, are not very effective (to say the least). It also acknowledges that there is room for the global community to contribute to the betterment of developing-nation health systems. From this, it can be inferred that global health is to some extent a common good akin to safe food and water. In particular, global health could be considered a common good in the sense that everyone (in both developed and developing nations) has some right to it, but also that everyone ought to promote it. In addition, a threat to it in any corner of the world impacts everyone else.
In developing countries, the Westphalian understanding of state sovereignty should not be sufficient to refuse global assistance when a country is not able to ensure the safety and security of its citizens. Moreover, a regime’s attention to public health should be one of the conditions of the legitimacy of its claim to sovereignty.
As for developed nations, global governance in health should not be in any way a threat to health in developing countries. Dr. Chan’s example of the tobacco industry is an apt one: wouldn’t the nearly 550 million dollars Australia spends annually to defend its right to introduce plain packaging for tobacco products be better spent on positive investments? Global health as a common good requires that citizens and corporations from developed nations apply the highest standards of good governance and ethics in all their operations worldwide.
Rising consciousness about the environment and corporate social responsibility (CSR) is good news. If health, like the environment, came to be seen as a global public good, it might ease international governance and collaboration between developed and developing nations in a public-private partnership (PPP) framework to promote better overall global health.
François Pazisnewende Kaboré, S.J. is a Jesuit priest from Burkina Faso and is the deputy director and academic secretary of the Jesuit University Institute.
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